2/18/2008

Shrinking In Treatment

We know that real dope dealers watch The Wire and that real mobsters watch The Sopranos, but do they blog about it? Some real-life shrinks who watch In Treatment do at the group psychiatry blog Shrink Rap. If you drew a Venn diagram of things that interest me about In Treatment and things that interest the shrinks, the overlapping portion would be rather slight. They are watching to see how the show represents therapy and the therapist. They watch in part as backseat drivers, offering diagnoses and clinical descriptions (e.g., Alex is narcissistic, Sophie’s environment is hostile). Maybe they fantasize about nudging Paul out of his comfy chair to offer their own counsel to his patients. The Shrink Rap bloggers also consider mental health concerns that the show raises and opine about the correct treatment of them--especially when it comes to ethical issues around patient-therapist attraction and a child's confession that requires a therapist to report, in violation of the patient's confidence, what has been learned in session. As for me, I care about the characters as characters rather than as models of patients or therapists (the shrinks do too, to be fair), the narrative form, the mise en scene, the shooting style, and the novelty of programming a prime-time prestige drama in daily installments, soap-style.

I have been wondering as I read the recaps, all written by one blogger called Dinah, if mental health professionals would have the same general expectations of the show’s therapy that I have. I thought I could tell from the first episode that In Treatment wasn't going for a very realistic portrayal, though I have never been in therapy myself. The sessions are shorter than the length of an episode, less than 25 minutes. Characters get up and walk around during their sessions and go to the bathroom. The space, in Paul's home, looks more like a living room than an office, and is cluttered with tchotchkes that reveal to us all sorts of things about the therapist’s interests and personality. Patients pay Paul in cash at the end of a session (he seems to find this vaguely disconcerting, and the metaphor they’re going for here would seem to be prostitution). They speak in speeches and seldom vocalize pauses or search for the right word. It’s theatrical rather than naturalistic. I’m learning to like this about it. I have learned from media representations of higher education to expect movies and TV to get the very basic things of any profession wrong and not to care too much about it.

Sometimes Dinah’s posts are more like recaps than analyses, and they read like notes taken during a real session. Reading these, I wonder if the show offers a way for a therapist viewer to feel moral judgment and personal affection in a way that might not feel right in reality. Dinah writes of the first Paul-Gina episode,

"Gina talks about how angry Paul was with her when he stopped coming 10 years ago, how he was so angry he didn't come to her husband's funeral. She talks about how Paul had accused her of interfering with his practice. Gina is retired. She's trying to write a novel. Go for it Gina! No wonder I like this show."

You can follow Dinah’s emotions cresting and crashing as the episode moves toward closure:

"I take it back, it's not a heated session, it's a Hostile session. I'm tense just watching these two people. 'You are not being helpful,' Paul says.

'What role have you assigned me?' Gina screams.

This is....therapy? supervision? oy. Gina tells him how hard it's all been on her, how confusing it is."

That “oy” is so awesome! (This isn’t just my Jewishness talking.) In those two short letters, oy conveys both frustration with the show—for failing to make Gina into either a supervisor or a therapist—and with the characters for being so unable to straighten things out properly.

Along the same lines, sometimes the tone is more irritated, and I wonder if watching an irritating patient in fictional therapy allows a therapist to get out some feelings that they might prefer not to feel about real patients: that some people are just boring, stupid, annoying, etc.

Sometimes I’m not sure why the Shrink Rappers keep watching a show they don’t seem to like all that much. Dinah keeps saying that watching gives her anxiety (well, what she says is that she needs Xanax). Sometimes watching is too much like work, not enough like leisure (“I want to go home. Oh, I am home.”) Even as they are hoping for realistic therapy, they get nit-picky about the details in a way that strikes me more as frustrated than fascinated (just what kind of therapist is Paul?). But every so often they make clear what interests them: the show is what a Freudian might call a wish fulfillment, a representation of therapy that is dramatic and eventful, where issues are really problems and the therapist is sage and empathetic. Dinah wonders if her fellow bloggers have ever had a patient come on to them as Laura comes on to Paul, and although she would want to avoid that as a professional, she clearly also has pangs of longing, of what-if, of wanting to be desired so badly that someone would transgress the boundary. Dinah makes this pretty clear in her first recap, when we learn of Laura’s attraction:

"'Laura, I'm your therapist, the parameters and limitations are established and ethically defined and not an option.' Go for it Therapist Paul."

Paul is something of an ideal to which Dinah aspires, a Hollywood shrink with looks and charisma and a charming accent who can pull off jeans with a blazer and never loses his cool or forgets what he was going to say (in therapy, anyway).

"He's a better shrink than I am any day, oh and that faint brogue to top it all off. When can I tell him my secrets?"

And then there is the pleasure of recognition.

"'It's 10 of and you probably have to turn on your cell phone now,' Sophie says to Paul. She asks Paul about his relationship with his daughter, she must call him at 10 of the hour. My real-life daughter and I laugh, I because I turn on my cell phone at 10 of the hour, my daughter because 'I always call you on the hour because that's when you answer.' Why aren't we on TV?"

I guess they get some things right.

And yes, I intend to keep blogging about this show. I have come to love it after my initial hostility. And I went searching for clips on YouTube of the Israeli original, to find that the wave machine, sailboats, and music were all there. My Hebrew's not good enough to tell you much more than that, unfortch.